3 New Year’s Resolutions on Behalf of Pain Patients

By Crystal Lindell

It’s now 2026, which means I’ve spent too many decades making mostly failed New Year’s resolutions for myself. So this year, I’m not going to bother.

Instead, I have some New Year’s resolutions for other people. Specifically, they’re for people with power, like doctors and healthcare policy makers.

After all, it really seems like they need to make some policy changes, given the current state of things for people in pain. Perhaps they are just waiting for someone to tell them what those changes should be. 

Below is a look at three of my 2026 New Year’s resolutions on behalf of pain patients..

Resolution # 1: Fully Legalize 7-OH and Develop New Edibles

There’s so many conflicting local regulations when it comes to kratom and 7-OH, despite the fact that neither one is as harmful as health officials and lawmakers often claim.

For those unfamiliar, 7-OH is short for 7-hydroxymitragynine, an alkaloid that occurs naturally in kratom in trace amounts. Some kratom vendors now sell concentrated versions of 7-OH to boost its potency as a pain reliever and mood enhancer.

A lot of pain patients find both 7-OH and kratom to be effective at treating chronic pain. And while I am glad that both are still legal in most places in the United States, I would really like to see them fully legalized across the country, as municipalities and states realize just how beneficial these products can be.

I also would really like to see 7-OH vendors come out with some new edible formats, like chocolates, gummies and even seltzer.

I think 7-OH in particular has the potential to help a lot of people who have been denied adequate pain treatment. However, many of them may not be comfortable figuring out where to buy and correctly dose a 7-OH chewable tablet, especially if they are among one of the largest demographic of pain patients: the elderly.  

I think of my grandma trying to get 7-OH tablets at a local smoke shop, or having to figure out how to order them online. Both options are bad. 

Ideally, regular grocery stores and local pharmacies would have a display of low-dose 7-OH chocolates available over-the-counter for pain patients like her.

Resolution # 2: Stop Prescribing Gabapentin and Tramadol for Pain

This would be such a relatively easy change for doctors to make, and there’s so much science to back it up.

In October of 2025, PNN covered a study showing that tramadol is often not effective for chronic pain. And PNN has long been covering how ineffective gabapentin is for most pain conditions.  

However, despite the evidence, doctors still regularly prescribe gabapentin and tramadol for chronic pain. 

It doesn’t have to be that way. Doctors have alternatives that actually work, most notably low-dose hydrocodone. Yes, there are more regulations around that medication, making it more difficult to prescribe. But actually giving pain patients real options shouldn’t be so difficult.  

So, I would like doctors and other healthcare professionals to make it their goal to stop prescribing ineffective medications. Instead, offer pain treatments that actually work. Your patients will thank you.

Resolution # 3: Implement Medicare for All

Yes, I know this one is kind of unrealistic. But that’s what New Year’s magic is all about —  putting whimsical ideas out into the universe with the hope of seeing them come to fruition. 

After all, it can’t happen if we never ask for it.

Unfortunately, as the year starts off, we are actually heading in the opposite direction, with many Americans seeing their health insurance premiums soar or even deciding not to buy coverage. 

But I’m hoping that may be the catalyst we need for the public to start demanding real change. Right now, millions of people are losing their health insurance because the Trump administration ended federal subsidies for coverage under the Affordable Care Act. 

It’s an awful and unnecessary situation that our policy leaders have the power to fix, if only they worked together on the issue.

Every human should have the right to healthcare, and Medicare for All would go a long way to making that happen.

I know a lot of these resolutions probably won’t come to fruition in 2026, but I do think they could realistically happen before we start the next decade. And all of them have the potential to vastly improve the lives of millions of people living with chronic pain.

Happy New Year everyone. May your 2026 be filled with low-pain days, too much joy, and lots of love.

A Pained Life: What's in a Name?

By Carol Levy

First, we were called “handicapped." It was a wholesale term to paint all those with physical, emotional or intellectual limitations. One inability meant total inability. Often, it was used as an exclusionary term, to mean someone was “less than.”

Eventually, it was realized that handicapped was a demeaning term. So, they changed it to “disabled.” That too was belittling — a word that tended to make us seem less than whole.

Then came physically (or emotionally or intellectually) “challenged.” That sounds better. After all, being challenged just means you have to try harder to meet goals and objectives.

But even that term carries a subtle meaning: we can overcome challenges if we just “try harder” or “do better.” It suggests we are too lazy, too much of a malingerer, and don't want to even try.

There has to be something better. In thinking about this, I had an “Aha!” moment: I am not disabled, I am “unable.”

That seems more appropriate. After all, being unable in one sense does not mean unable in all. "I am unable to answer the phone right now. Please call back later.".

Because of my trigeminal neuralgia, I can't use my eyes for more than 15 -20 minutes without severe pain. I can't tolerate wind or even a slight breeze against the affected side of my face.

But the rest of me is able and willing. It only makes me unable to do things that require the use of my eyes. I am still able to do things that are physically demanding. I can walk, talk, think, exercise, and thankfully take care of myself. That is far from being disabled. 

Others among us may be unable to lift things, clean a room, or even walk. But we can still think, talk, read, and interact with others, even if only on the phone or online.  We are “unable” in part, but able in many other ways.

But, at the end of the day, does the term used to describe those with inabilities really matter? Most healthy people don’t even consider the label, it’s just a way of quickly describing someone.

Quick descriptions, though, lead to stereotypes and misunderstandings. Take, for example, someone parking in a “handicapped” parking spot.

They may have the placard or license plate that gives them permission to park in these spaces, but when they exit their car and start to walk away, another person may object. They’ll start yelling, “You're not handicapped! How dare you park there and take the space away from someone who actually needs it!”

I have had this happen to me. But it’s too hard to explain what trigeminal neuralgia is, and how the wind or even a breeze could set off a pain flare.

Instead, I say, “I do not need to have a cane or wheelchair to be disabled. I may have a heart condition or emphysema or any number of other disorders that make it difficult for me to park farther away from the entrance.”

Looking abashed, if you're lucky, the person walks away.

It would be nice and so much easier, if I could respond by saying “You're right. I am not handicapped in the way you expect me to be. I am unable physically in a way that may be invisible to you, but necessitates my using this spot.”

I keep my fingers crossed, hoping it’s a teachable moment, that this person will understand that “unable” in one sense does not mean unable in all. Maybe, if we're all really lucky, she’ll be able to pass it on.

Carol Jay Levy has lived with trigeminal neuralgia, a chronic facial pain disorder, for over 40 years. She is the author of “A Pained Life, A Chronic Pain Journey.”  Carol is the moderator of the Facebook support group “Women in Pain Awareness.” Her blog “The Pained Life” can be found here.  

On a Scale of 1 to 10…

By Julie Titone

Pain is the most common reason that people see a primary care doctor. If you have chronic pain – the kind that’s stuck around for three months or more – chances are you’ve seen lots of specialists, too. 

You may dread their standard question as much as I do: “On a scale of 1 to 10, how much pain do you feel, with 10 being the worst pain possible?”

I hesitate to answer. If I say 6, will I feel like a whiner? If I say 5, will my pain be taken seriously? 

How would I know if I felt the worst possible pain? 

Are you asking me how much it hurts when I stand or when I sit?

There is value in trying to quantify pain, and many have tried to improve upon the 10-point scale. But pain can never be captured by numeric language or, for that matter, by the English language. Good doctors are less interested in numbers than in how the pain is affecting someone’s life.

This subject is on my mind because of the responses to my column, “Arachnoiditis: My Not-So-Rare Disease.” 

Readers who share my diagnosis of adhesive arachnoiditis told me they appreciated my effort to spread the word about this chronic inflammatory disease. But a few chided me for downplaying how painful arachnoiditis can become. 

Here is what I wrote: “Patients experience lower body numbness and stinging pain that, at its worst, is likened to hot water dripping down the legs. The disease can lead to paralysis and bladder dysfunction.”

I debated which words to use in that paragraph. A litany of misery might cause folks to stop reading, so I kept the descriptive list short. 

Now, in recognition of those who suffer, I will expand upon the kinds of pain reported by arachnoiditis patients:

• Burning, stabbing, shocking, zapping

• Buzzing, icy hot, insects crawling under the skin. 

• Deep aching/boring in the spine. 

• Pain radiating down the back of the legs. 

• Vice-like pressure. Cramping. 

• Pain that increases upon standing or sitting. 

• Sudden flares triggered by movement. 

• Widespread burning in the lower body. 

• Pelvic, abdominal and bladder-related pain. 

• Unrelenting, throbbing, exhausting pain.

As one woman wrote in an online discussion: “How much can a body take?” 

Some patients would answer that question with suicide.

What makes this all doubly sad is that arachnoiditis often begins when people seek relief, via injections or surgery, from another source of pain.

So far, my own arachnoiditis is not debilitating. I get modest relief from medicines, movement and massage. Distraction helps. If you need advice on the best ice packs and seat cushions, I’m your gal.

Chronic pain plagues an estimated 20 to 30 percent of people in the world at any given time. The cliché goes that misery loves company. I don’t love it, but that massive company could work in my favor someday.

Researchers have 2 billion reasons to investigate pain treatment and prevention. As the secrets of neural pathways are unlocked, the knowledge is bound to benefit those of us with arachnoiditis.

Julie Titone is a former newspaper journalist who also worked in academic and library communications. She is retired and lives in Everett, Washington. Julie’s website is julietitone.weebly.com.

This column first appeared in Julie’s Substack blog and is republished with permission. 

Congress Went Home for Holidays, Leaving Millions to Face Rising Healthcare Costs

By Robert Applebaum

Dec. 15, 2025 – the deadline for enrolling in a marketplace plan through the Affordable Care Act for 2026 – came and went without an agreement on the federal subsidies that kept ACA plans more affordable for many Americans. 

Despite a last-ditch attempt in the House to extend ACA subsidies, with Congress adjourning for the year on Dec. 19, it’s looking almost certain that Americans relying on ACA subsidies will face a steep increase in health care costs in 2026.

As a gerontologist who studies the U.S. health care system, I’m aware that disagreements about health care in America have a long history. The main bone of contention is whether providing health care is the responsibility of the government, or of individuals or their employers.

The ACA, passed in 2010 as the country’s first major piece of health legislation since the passage of Medicare and Medicaid in 1965, represents one more chapter in that long-standing debate. That debate explains why the health law has fueled so much political divisiveness – including a standoff that spurred a record-breaking 43-day-long government shutdown, which began on Oct. 1, 2025.

In my view, regardless of how Congress resolves, or doesn’t resolve, the current dispute over ACA subsidies, a durable U.S. health care policy will remain out of reach until lawmakers address the core question of who should shoulder the cost of health care.

The ACA’s Roots

In the years before the ACA’s passage, some 49 million Americans – 15% of the population – lacked health insurance. This number had been rising in the wake of the 2008 recession. That’s because the majority of Americans ages 18 to 64 with health insurance receive their health benefits through their employer. In the 2008 downturn, people who lost their jobs basically lost their health care coverage.

For those who believed government had a primary role in providing health insurance for its citizens, the growing number of people lacking coverage hit a crisis point that required an intervention. Those who place responsibility on individuals and employers saw the ACA as perversion of the government’s purpose. The political parties could find no common ground – and this challenge continues.

The major goal of the ACA was to reduce the number of uninsured Americans by about 30 million people, or to about 3% of the U.S. population. It got about halfway there: Today, about 26 million Americans, or 8%, are uninsured, though this number fluctuates based on changes in the economy and federal and state policy.

Health Insurance for All?

The ACA implemented an array of strategies to accomplish this goal. Some were popular, such as allowing parents to keep their kids on their family insurance until age 26. Some were unpopular, such as the mandate that everyone must have insurance.

But two strategies in particular had the biggest impact on the number of uninsured. One was expanding the Medicaid program to include workers whose income was below 138% of the poverty line. The other was providing subsidies to people with low and moderate incomes that could help them buy health insurance through the ACA marketplace, a state or federal health exchange through which consumers could choose health insurance plans.

Medicaid expansion was controversial from the start. Originally, the ACA mandated it for all states, but the Supreme Court eventually ruled that it was up to each state, not the federal government, to decide whether to do so. As of December 2025, 40 states and the District of Columbia have implemented Medicaid expansion, insuring about 20 million Americans.

Meanwhile, the marketplace subsidies, which were designed to help people who were working but could not access an employer-based health plan, were not especially contentious early on. Everyone receiving a subsidy was required to contribute to their insurance plan’s monthly premium. People earning US$18,000 or less annually, which in 2010 was 115% of the income threshold set by the federal government as poverty level, contributed 2.1% of their plan’s cost, and those earning $60,240, which was 400% of the federal poverty level, contributed 10%. People making more than that were not eligible for subsidies at all.

In 2021, legislation passed by the Biden administration to stave off the economic impact of the COVID-19 pandemic increased the subsidy that people could receive. The law eliminated premiums entirely for the lowest income people and reduced the cost for those earning more. And, unlike before, people making more than 400% of the federal poverty level – about 10% of marketplace enrollees – could also get a subsidy.

These pandemic-era subsidies are set to expire at the end of 2025.

Cost vs Coverage

If the COVID-19-era subsidies expire, health care costs would increase substantially for most consumers, as ACA subsidies return to their original levels. So someone making $45,000 annually will now need to pay $360 a month for health insurance, increasing their payment by 74%, or $153 monthly. What’s more, these changes come on top of price hikes to insurance plans themselves, which are estimated to increase by about 18% in 2026.

With these two factors combined, many ACA marketplace users could see their health insurance cost rise more than 100%. Some proponents of extending COVID-19-era subsidies contend that the rollback will result in an estimated 6 million to 7 million people leaving the ACA marketplace and that some 5 million of these Americans could become uninsured in 2026.

Policies in the tax and spending package signed into law by President Donald Trump in July 2025 are amplifying the challenge of keeping Americans insured. The Congressional Budget Office projects that the Medicaid cuts alone, stipulated in the package, may result in more than 7 million people becoming uninsured. Combined with other policy changes outlined in the law and the rollback of the ACA subsidies, that number could hit 16 million by 2034 – essentially wiping out the majority of gains in health insurance coverage that the ACA achieved since 2010.

Subsidy Downsides

These enhanced ACA subsidies are so divisive now in part because they have dramatically driven up the federal government’s health care bill. Between 2021 and 2024, the number of people receiving subsidies doubled – resulting in many more people having health insurance, but also increasing federal ACA expenditures.

In 2025, almost 22 million Americans who purchased a marketplace plan received a federal subsidy to help with the costs, up from 9.2 million in 2020 – a 137% increase.

Those who oppose the extension counter that the subsidies cost the government too much and fund high earners who don’t need government support – and that temporary emergencies, even ones as serious as a pandemic, should not result in permanent changes.

Another critique is that employers are using the ACA to reduce their responsibility for employee coverage. Under the ACA, employers with more than 50 employees must provide health insurance, but for companies with fewer employers, that requirement is optional.

In 2010, 92% of employers with 25 to 49 workers offered health insurance, but by 2025, that proportion had dropped to 64%, suggesting that companies of this size are allowing the ACA to cover their employees.

Dueling Solutions

The U.S. has the most expensive health care system in the world by far. The projected increase in the number of uninsured people over the next 10 years could result in even higher costs, as fewer people get preventive care and delayed health care interventions, ultimately leading to more complex medical care

Federal policy clearly shapes health insurance coverage, but state-level policies play a role too. Nationally, about 8% of people under age 65 were uninsured in 2023, yet that rate varied widely – from 3% in Massachusetts to 18.6% in Texas. States under Republican leadership on average have a higher percentage of uninsured people than do those under Democratic leadership, mirroring the political differences driving the national debate over who is responsible for shouldering the costs of health care.

With dueling ideologies come dueling solutions. For those who believe that the government is responsible for the health of its citizens, expanding health insurance coverage and financing this expansion through taxes presents a clear approach. For those who say the burden should fall on individuals, reliance on the free market drives the fix – on the premise that competition between health insurers and providers offers a more effective way to solve the cost challenges than a government intervention.

Without finding resolution on this core issue, the U.S. will likely still be embroiled in this same debate for years, if not decades, to come.

Robert Applebaum, PhD,  is a Senior Research Scholar in the Department of Sociology and Gerontology at Miami University. He is also Director of the Ohio Long-Term Care Research Project and Senior Research Scholar at the Scripps Gerontology Center.

This article originally appeared in The Conversation and is republished with permission.

My Christmas Wishes for Pain Patients

By Crystal Lindell

With Christmas spirit in the air, and the hope of the New Year close behind, it seems only appropriate to make some holiday wishes for all my fellow pain patients.

Here are my wishes for people in pain:

More low-pain days than not. Easy opioid prescription refills. Clothes that don’t hurt to wear. Supportive family that always believes you and never judges you.

The ability to use a cane, the possibility of not needing it, and the wisdom to know the difference.

I wish for you a sweet pet to cuddle up in your lap whenever you can’t get off the couch. Money that comes in more than it goes out. And steady weather, so that the barometric pressure doesn’t increase your pain.

I wish that every book you read to get through a pain flare takes you to a new world where your pain isn’t as bad.

I wish for you a doctor who takes you seriously and prescribes you medications that actually work. Health insurance that actually covers all of your medical expenses. And a pharmacist who actually believes you.

I wish you more strength that you need to keep going when the pain is really trying to make you stop. And the ability to keep hope alive even when you’d rather be dead.

If you’re seeking answers and a diagnosis, I hope you find both. 

If you’re seeking a romantic partner, I hope they find you. 

If you’re just seeking a good TV show to watch on bad pain days, I hope you find one with lots of seasons. Hopefully, it’s on one of the streaming services you already subscribe to!

May your naps always rejuvenate you, your medications always kick in quickly, and your shoes always be comfortable.

But most of all, my wish for you is that your pain goes away. I really do.

Sadly, like my body, my wishes don’t always work so well. They only rarely come true. 

So, if your pain refuses to leave, I wish only that you know that this world needs you in it, and that it’s vitally important that you keep going. There are still so many things left for you to see and do and accomplish. 

Merry Christmas dear pain patient, and hopefully a very happy New Year – or at least a survivable year ahead.

I See Doctors All the Time, But They Won’t Treat My Pain

By Neen Monty

I am in complete overwhelm right now. It has been far too much, for far too long.

As I write this, in the last ten days alone, I’ve had seven medical appointments or treatments:

• Two GP visits.

• One neurologist appointment. And the news wasn’t great.

• My fortnightly IVIG infusion.

• A consult with a new pain management doctor. It did not go great.

• The introductory session for the public pain clinic. The first step in a very long process to see the doctor I was referred to.

• A psychologist appointment.

That’s seven appointments in ten days.

This is what being seriously ill looks like. This is what living with a disabling, incurable disease looks like.

I don’t choose for my life to revolve around my disease. The disease chooses. The disease dictates my schedule, my energy, my mobility, my ability to work, and my ability to participate in life.

When you’re very unwell, with a serious, progressive and incurable disease, there is no choice. You don’t get to opt out. You don’t get to think happy thoughts, and everything magically gets better.

You don’t get to postpone or not feel up to it today. You don’t get to decide what you do with your four functional hours a day. Your illness becomes the architect of everything.

People say, “Why don’t you try harder?”

Try what, exactly? Try not being sick? Thanks, that’s really helpful advice.

Instead of empathy, I get blamed.

You should change your diet. You should exercise more. You should get out more. You should try grounding. You should try Bowen therapy. You should read this great book I just read, it’s sooooo motivational!

You should read up on stoicism, it would help you be tougher. You should stop taking all those medications. Pharma makes customers, not cures, you know. Never mind that if I stop taking just one of my medications, I will die.

They are all saying, “You should try being not sick.”

The truth is that they don’t want to hear about it. It’s boring. And you’re exaggerating. You’re malingering. You’re not strong enough. You’re not positive enough. You are not enough.

Not one of these people has taken a moment to even consider what my life is really like. What it’s like to wake up sick and in terrible pain, every single day. Usually at around 3am.

That’s when my day starts. That’s when I start battling the pain. It’s truly a very difficult existence.

But instead of empathy and support, I get belittled. Dismissed. Treated as if pain — the most defining and disabling part of my disease — is somehow optional, psychological, or a personal and moral failing.

Something that I chose. Something I did wrong. Or something I didn’t do right.

Because people like to believe that everything happens for a reason. Spoiler: It doesn’t.

And that bad things don’t happen to good people. Spoiler: They do.

Doctors will treat the disease. But they refuse to treat the pain the disease causes.

And honestly, what’s the point? If you’re not going to treat the pain, how can you call yourself a doctor? How can you pick and choose what you will and won’t treat? And who you will and won’t help?

Pain is not my only disabling symptom. I have significant muscle weakness that is noticeably progressing.

I try to exercise, even though it usually makes things worse before it makes anything better. I hope it’s going to make me stronger long term. I don’t know that, but it’s my best hope. So I take my dogs on a slow jog and walk, and hope for the best. Always looking on the bright side.

Pain? It’s getting worse. No question. That’s disease progression. And maybe opioid tolerance in play.

But every doctor says the same thing: “You cannot have a higher opioid dose. No matter how bad the pain is.”

This isn’t medicine. It’s barbarism. It’s cruelty.

This is politics dressed up as healthcare. Policy made by people who are not doctors or scientists, and not interested in the terrible pain they cause. Yet they call it “evidence-based” and “best practice.”

These are rules made by people who will never experience what they’re inflicting. Because we know when doctors and politicians are in the hospital, they get opioids.

Just not us normal folk. The little people. We don’t matter, apparently.

Every week I talk to medical professionals, trying to understand why it’s like this. I don’t want to argue, I want to learn. Is this clinician bias I am looking at? Or is this what they’re all being taught?

Answer: It’s systemic. Doctors are being taught myths based on lies. And they don’t have time to check the science. If they did, they would be horrified at the patient harm they have caused and the lack of evidence for their decisions. But they’ll never check, so…

They have literally been trained to believe that education is more effective than opioid pain medication. How can any intelligent person believe that? It blows my mind.

They are taught that pain is “psychological” or caused by a “hypersensitive nervous system.” It has nothing to do with tissue damage, inflammation, disease or pathology.

Which is 100% wrong in every case.

We have a generation of clinicians who see pain not as a serious medical symptom, but as a faulty thought pattern. A cognitive glitch. A mindset problem.

Do you know what that belief system does? It erases empathy. Because why feel compassion for someone who is “catastrophising?” Why help someone whose pain is “in the brain,” which they can change themselves?

Why treat the suffering of someone who just needs to understand pain better?

I can always tell the exact moment a clinician realizes my pain is pathological and that their program, book, or brain training technique won’t work on me.

It’s like a curtain drops. Their interest vanishes. Their warmth evaporates. They stop asking questions. They stop seeing me as anything other than a problem.

Only one person in the last fortnight showed actual empathy — the sort of basic human response that should be universal when you have a severe, progressive, incurable, and painful disease. Every human being should be able to say, at the very least, “I’m so sorry you’re dealing with that.”

But only one did. I spoke to two physical therapists and one GP on social media. Asking them questions, hoping to learn. I answered their questions, but they didn’t answer mine. And as soon as they realized I would be of no use to them, they ghosted me.

Only one took the time to say, “I’m so sorry this has happened to you.”

My story is terrible. I have been abandoned, ignored, demonized, stigmatized, misdiagnosed and refused the most basic care. Any normal human being should be horrified by my story and the reality of my life. Of the pain I am forced to endure.

But only one showed me any empathy at all.

Mostly what I get is coldness. Defensiveness. Blank stares. Silence.

Not my problem-ism.

These are the people we rely on. The people who decide whether we get treatment, whether we get relief, whether we get to have any quality of life at all.

My life is not my own. I am not choosing this. No one would.

I’m trying to survive a body that is failing me and a system that refuses to see what pain really is — a physical experience rooted in biology, pathology and disease, that is sometimes influenced by psychological and sociological factors.

Not a mindset. Not a belief. Not a psychological construct.

The hardest part of being sick isn’t the disease. It’s fighting for your life while the system fights against you.

Neen Monty is a patient advocate in Australia who lives with rheumatoid arthritis and Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), a progressive neurological disease that attacks the nerves.

Neen is dedicated to challenging misinformation and promoting access to safe, effective pain relief. For more information on chronic pain, the science, the politics and the lived experience, got to Pain Patient Advocacy Australia. You can also subscribe to Neen’s free newsletter on Substack, “Arthritic Chick on Chronic Pain.”

Medical Assistance in Dying: When Is Enough, Enough?

By Ann Marie Gaudon

Google AI defines the phrase "enough is enough" as a personal judgment that continued effort or tolerance is no longer beneficial or sustainable. When you are trying to fix a problem and you've exhausted all reasonable options, it's a signal that you need to let go and move on. 

If only we knew where moving on is meant to be.

If you’ve been following along, you will know I have lost a few friends to Medical Assistance in Dying (MAiD) here in Canada. I have written about Maggie and Melissa,who both ended their lives after struggling for years to meet MAiD’s requirements, which include having an “irrevocable and grievous medical diagnosis” that could not be cured or treated.

Some people call it “assisted suicide.” I don’t particularly like that term, only because the word “suicide” itself comes with centuries of baggage.

It’s Canadian law that an individual may not have a foreseeable death. However, if they are suffering to an extent that they choose to die, then they can access the MAiD option – what is supposed to be a peaceful, dignified death. 

It’s not as easy as the law sounds. Maggie’s choice took well over two years and only happened because her medical practitioner pushed for it. For Melissa, it never came first or last. My heart ached for her. Just because you are qualified to receive MAiD, doesn’t mean that you’re going to get it – and that frightens me.

Physically, things are not going well for me lately. What if I’m ready to leave this earthly body and no one will help me do it peacefully? 

You might already know that I am an advocate for personal choice in dying. That means a person’s right to choose for themselves only. But how does one even make this decision? When is enough, enough? 

I would think that relief of suffering is the most important factor in the decision to access MAiD. If you are actually dying, MAiD will provide you with a very peaceful and humane death. 

But I don’t think this is fair to a person living with pain who is not dying, but is suffering too much to cope or have any meaningful quality of life. 

I don’t think there should be a difference, however there is. There is a great reluctance for the MAiD doctors to provide assistance in dying to a person in pain. There’s a tendency instead to diagnose them with a mental illness — which then disqualifies them for MAiD.

A lack of support would surely be another factor in the decision for or against MAiD. I am eternally grateful for my inner circle and their support. Even if they hated the idea of MAiD for me (which they would), I would still receive their support if I was very certain I wanted to end my suffering forever. Unconditional love is what it’s all about.

Speaking about loved ones, I now have another one that has changed everything for me: a grandchild. He is nine months old as I write this and a ball of love and sunshine all rolled into one. How could anyone not want to see him grow? Be a part of his life? Be a beloved grandparent? 

I sit here crying as I write this to you. I can’t speak for others, but this grandchild has changed everything about how I feel regarding my own death – that is, if I even have a choice in the matter. Unknowingly, he has taken the priority off of myself as a candidate for MAiD and become the priority.

I think I’m asking a question that there is no answer to, at least cognitively. Perhaps enough is enough when you feel it. Even if you don’t have the language to explain it, maybe it is a feeling? 

Our minds have evolved to be great problem-solving machines, but what if the problem cannot be solved? It’s a conundrum. My chronic pain and illness cannot be solved, and with each passing year I feel physically worse than the year before.

That does not equate, however, to feeling emotionally worse. That is not my case. Perhaps my age has allowed me to give up a lot of the emotional struggle and grab a handful of happiness whenever I can. I can laugh easily and heartily at the healthy moments of life, yet my body is breaking beneath me. What does one do with this scenario?

For one, I am not convinced that although I legally qualify for MAiD, that it would actually be completed. For two, now with a grandchild in the mix, everything has been upended for me. 

What I thought I would do is now what I don’t want to do. The big problem is my body is breaking beneath me. I have acquired a world of coping skills, but they do not work when the pain is severe. 

How long do I suffer because I can’t bear to leave others? There is no answer for this and I damned well know it.

Ann Marie Gaudon is a registered social worker and psychotherapist in the Waterloo region of Ontario, Canada with a specialty in chronic pain management.  She has been a chronic pain patient for over 30 years and works part-time as her health allows. For more information about Ann Marie's counseling services, visit her website.   

Most Americans Want Federal Government to Ensure Healthcare Coverage

By Crystal Lindell

Two-thirds of Americans (66%) say the federal government has a responsibility to make sure everyone has healthcare coverage. That’s according to a new Pew Research Center survey of over 10,000 U.S. adults conducted last month.

While these views are essentially unchanged over the last year, they are somewhat higher than they were in 2021, when 62% of Americans said the government has a responsibility to make sure everyone is covered by health insurance. 

Pew said the increase is primarily due to more Republicans (42%) supporting the idea. However, they are outnumbered by Republicans and Republican-leaning independents who believe the federal government has no business ensuring healthcare coverage for anyone (59%).

In contrast, a solid majority of Democrats and Democratic-leaning independents (90%) say the government has a responsibility to ensure coverage. 

While there is broad support for healthcare coverage overall, Americans disagree on how that should be achieved.

Over a third (35%) favor a single national government program, while 31% say insurance should be provided through a mix of government and private programs.

About one in four adults (26%) say government coverage should only be provided through Medicare and Medicaid, and 7% believe there should be no government involvement of any kind.

PEW RESEARCH CENTER

Adults in lower-income households are significantly more likely to support federal involvement, regardless of political affiliation. Sixty percent of Republicans with lower incomes favor a government-run program of some kind. That includes 27% who say it should be done through a single national insurance program.

Meanwhile, large majorities of Democrats at all income levels say the federal government is responsible for ensuring everyone has health coverage. 

Among racial groups, 85% of black people favor government-run coverage, followed by Asians (78%), Hispanics (75%) and white people (59%). 

Younger people are more likely to believe the government has a responsibility to provide healthcare coverage. Specifically, 74% of 18-29 year olds said this, followed by 67% of 30-49 year olds; 63% of 50-64 year olds; and 62% of those over 65. 

While a large majority of Americans believe the federal government should play a role in providing insurance to everyone, the political appetite for such a move is not supported in Congress or by the Trump Administration.

This week, the U.S. Senate voted down two competing proposals. One, supported by Democrats, would have extended the Obamacare subsidies without any strings attached. The other proposal, backed by Republicans, would have continued some subsidies, provided the money could not be used for abortion or gender-transition procedures.

The White House, meanwhile, is working on its own plan to give money directly to people so they can buy their own health insurance. But few specifics have been made public.

Barring any last minute breakthroughs, 24 million Americans will face significantly higher insurance premiums on January 1, when federal subsidies for the Affordable Care Act end.

A Doctor’s Appointment Can Feel Like Criminal Court for Pain Patients

By Crystal Lindell

This week I had an appointment where I was worried that I would have to submit to a urine drug test. And if anything went wrong, it could ruin my life.

It wasn’t a criminal court date or a meeting with a probation officer. It was with my doctor.

Every six months, I have to see the doctor who prescribes my opioid pain medication for a check-in. I’m actually very lucky that I only have to see him twice a year, because many patients are required to go in much more frequently.

But those two appointments each year cause me so much stress that I have trouble functioning. There is always the fear that if something doesn’t go according to plan, my opioid prescriptions could be cut off. And when a doctor has that much power over you, it’s rational to worry about how things will go.

So, in the weeks leading up to the appointment, I stress about everything that could go wrong.

Chief among my worries is that I haven’t had health insurance since 2022, so now a lot of my previous medical bills are in collections. Mind you, even when I had insurance, a lot of my medical bills went to a collections agency because, between co-pays and deductibles, the bills were in the thousands of dollars.

I always worry that this be the visit when my doctor finally cuts me off from care because of unpaid bills. Or maybe it will be the front-desk receptionist who confronts me about the overdue bills. What do I do if they refuse to see me as a patient because I am late paying? While it’s a decision that would fully be within their rights, it would ruin my life.

I have good reason to fear this. In 2008, I got an HPV vaccine from a doctor, and the shot came with a $150 co-pay. I had just finished paying thousands of dollars in medical bills for my gall bladder removal surgery, so I was having trouble paying for the vaccine.

And then, out of the blue, I got a letter from that doctor’s office saying that they were cutting off my care because of the unpaid bill. And I was no longer allowed to get care at any of the doctors in that hospital system.

I was shocked and sad, and also thankful that I was moving out of the area soon. But the experience scared me and left me constantly worried that even small unpaid medical bills could result in a doctor abandoning me.

Money isn’t the only stress factor when it comes to these appointments. There is also the chance of a urine drug test going wrong. While my doctor has not ordered one in a while, it’s always a possibility.

Now, you might assume that since I take my medications as prescribed, there should be nothing to worry about when it comes to peeing in a cup. But if anything does go wrong, I could lose access to the medications that I need to function. Like if there’s a false result on the screening, which happens more often than you might think.

So, I stress.

A lot of people assume that drug tests only look for non-prescribed or illicit substances. That what they are really looking for is cocaine and heroin. But the tests go far beyond that, and they are constantly adding substances to check for. While they have never tested for kratom in the past, I have no idea if it will suddenly be added to the screening, and what would happen if I tested positive for it.

The real reason most doctors order drug tests is they want to make sure you are taking your opioid medication as prescribed. If the medication isn’t found in your urine, that means you might be selling or diverting it. 

Again, not a problem for me. But still, the act of being forced to pee in a cup for the sole purpose of policing my compliance with the doctor is always going to feel punitive.

All of these worries are rolling around in my brain when the day of the appointment arrives. I have to wake up earlier than normal to shower and make the drive to the doctor’s office. It’s almost two hours each way because he works at the closest university hospital, and my complex medical needs require more than a local primary care doctor can handle.

My body hates waking up early, and my chronic pain often flares up in rebellion if I don’t get enough sleep. So, I have to ease into functioning while waiting for my pain medication to kick in.

All of this stress is compounded by the fact that on the day of this particular appointment it was snowing, with a mix of rain and sleet hitting the ground in just the right way to make all the roads extremely icy.

I knew this was going to make driving difficult, but I also knew that if I canceled my appointment, I risked not being able to get my next pain medication refill. So I prepared myself for an extremely treacherous drive and planned to leave a full hour early

Before I was set to leave, my fiancé went to the local Casey’s gas station to fill up the car for me. When he came back he sounded like he had been to war: “You can’t drive to your appointment in this weather! People were literally spinning out in the Casey’s parking lot!”

Ugh. Fine. I decided to suck it up and call my doctor’s office to see what my options were because I knew the weather was too bad to drive.

I assumed that I would need to completely reschedule, because he’s usually booked out for months. But when I called, the receptionist said that in the notes my doctor had said that I could do the appointment virtually if needed.

I once heard that wearing different colored socks brings good luck, and thus I have done this many times throughout my life on stressful days. And this time, it actually worked!

I was able to do a very easy telehealth call, from the comfort of my own home! Everything went extremely well. He told me that he had seen the weather, and that I had made the right call to stay off the roads that day. I had spent all that time stressing for nothing. 

But it shouldn’t take a pair of mismatched socks to get compassionate care. Millions of chronic pain patients are constantly stuck navigating these types of appointments because of the war on opioids. Unfortunately, many of them end up living the things that I feared. 

Of course, in six months’ time, I will have to go to his office again, and I’m sure I’ll go through all the same stress before that appointment too. Hopefully by then I’ll have some sort of health insurance, and ideally it will be a clear summer day..

Until then, I’m just happy that my doctor decided to rule in my favor. In an ideal world, a doctor’s appointment shouldn’t feel like a verdict.

A War on Drugs That Bombs Boats, Pardons Narco-State President, and Prosecutes Doctors

By Dr. Lynn Webster

On September 1, 2025, a U.S. warplane blew apart a small speedboat in the Caribbean, killing all eleven people on board. President Trump released the video like a trailer for a new season of a drug war TV series, boasting that the vessel was loaded with narcotics and crewed by Venezuelan “narco-terrorists.”

The strike was the opening salvo in a new campaign of air attacks on suspected drug boats in the Caribbean and eastern Pacific — Operation Southern Spear — that has killed at least 87, all on the strength of the administration’s unproven claims about who was on board and what cargo they were carrying.

On December 1, the same administration quietly did something very different. It issued a “full and complete pardon” to former Honduran president Juan Orlando Hernández, who was convicted in a U.S. federal court of helping move more than 400 tons of cocaine into the United States and running Honduras as what prosecutors called a “narco-state.”

Hernández was serving a 45-year sentence when the pardon came through. The White House justified the move by claiming the trial was “politicized” under the prior administration and that Hernández was the victim of overzealous prosecutors relying on compromised witnesses.

So, in the space of a few months, we have a government that claims the authority to kill alleged drug traffickers on the high seas without a trial, while freeing a former head of state that U.S. courts found to be deeply enmeshed in the cocaine trade.

At the same time, ordinary physicians inside the United States continue to be charged as “drug dealers in white coats” for prescribing opioid analgesics to patients in pain—often amid clinical uncertainty and shifting standards of care.

Drug Control by Spectacle

Together, the boat killings, the Hernández pardon, and the prosecution of well-intended physicians reveal something fundamental about the modern American war on drugs: It is less a coherent public-health strategy than a flexible political script.

Consider Hernández. For years, he was treated as a reliable U.S. ally, an eager partner in migration control and anti-drug cooperation. Only after he left office did the Justice Department present evidence that his government functioned as a protection racket for traffickers, with bribes flowing in and cocaine flowing north.

A New York jury convicted him; a federal judge imposed a 45-year sentence; and families ravaged by the cocaine trade were told this was a landmark in the fight against high-level corruption.

Yet, with the stroke of a pen, that message has been reversed. The pardon has been widely read in Honduras as an intervention on behalf of Hernández’s political allies, and it signals that even the most spectacular narcotics conviction is negotiable if the defendant is useful to Washington.

Now, set that alongside the first boat killing and the broader air campaign that followed. Under Operation Southern Spear, U.S. forces have been authorized to strike suspected drug-running vessels in international waters, killing dozens of people so far in the Caribbean and Eastern Pacific.

Human-rights experts call this an extrajudicial killing regime. They cite the fact that there has been little transparency and no meaningful process to distinguish a trafficker from, say, an unlucky fisherman who happened to be in the wrong place at the wrong time.

This is drug control by spectacle. It projects toughness and reassures a domestic audience that someone is paying the price for drug trafficking. But it does little to reduce supply, and it risks deepening resentment in countries that already bear the brunt of the U.S.’s drug policy.

Physicians Targeted

Meanwhile, inside the United States, the same punitive mindset has migrated into medicine. Under the Controlled Substances Act, doctors commit a crime if they “knowingly or intentionally” distribute or dispense controlled substances in an unauthorized way.

In our amicus brief in Ruan v. United States, my co-authors and I explained how prosecutors have increasingly treated alleged deviations from the “standard of care” as proof that a prescription lacked a “legitimate medical purpose in the usual course of professional practice.” This effectively turned malpractice or medical guideline disputes into drug-trafficking charges, and eroded the requirement that the government prove a guilty mind.

In the Ruan ruling, the Supreme Court unanimously held that the government must show that a prescriber knew their conduct was improper and illegal.

Yet for many clinicians, the message from years of aggressive prosecutions is that prescribing opioids to patients with complex pain conditions can be a fast track to a felony indictment. Physicians have watched colleagues led from their offices in handcuffs, their careers and reputations destroyed, sometimes on the basis of retrospective judgments about “red flags” rather than evidence of deliberate criminality.

Put crudely, our system has developed three very different responses to people labeled “drug traffickers.”

If you are a poor person on a boat in the Caribbean, you may be killed without a trial.

If you are a former president whose government helped move hundreds of tons of cocaine, you may be pardoned.

If you are a physician treating complex pain patients in a fragmented, under-resourced health system, you may be prosecuted as a drug dealer if your prescribing patterns later look suspicious on a spreadsheet.

That is not a rational drug policy. It is a hierarchy of whose lives are expendable, whose conduct is negotiable, and whose mistakes are treated as crimes.

None of this is to deny that real traffickers wield violence and that some clinicians have abused their prescribing privileges. But when we glorify lethal force at sea, quietly forgive a leader of what U.S. prosecutors themselves called a narco-state, and simultaneously treat legitimate clinical judgment as suspect, we are no longer talking about a war on drugs.

We are talking about a war on certain kinds of people: the poor, the foreign, the sick, and medical professionals all serve as convenient scapegoats.

If we are serious about reducing overdose deaths and drug-related harm, we need to abandon the theatrics. That means three things.

First, we must subject military operations to rigorous legal and human-rights scrutiny.

Second, we must acknowledge that pardoning a convicted narco-president while bombing alleged couriers does not “send a message” of resolve. It sends a message of incoherence — and of a system more invested in performance than in justice or saving lives.

Third, once and for all, we must end the use of criminal law to second-guess good-faith medical practice.

Lynn Webster is a physician specializing in pain and addiction medicine, a former president of the American Academy of Pain Medicine, Senior Fellow at the Center for U.S. Policy, and author of “The Painful Truth” and the forthcoming book “Deconstructing Toxic Narratives – Data, Disparities, and a New Path Forward in the Opioid Crisis.” He has written extensively on drug policy, the opioid crisis, and the criminalization of medicine.  

Feline Good: A Sense of Purpose Helps Me Manage Chronic Illness

By Crystal Lindell

Every morning, at around 5 a.m., my very fat orange cat Goose starts his daily routine: Screaming at the top of his lungs in an effort to wake up me and my partner.

He’s hungry and he doesn’t care if we’re asleep – it’s time for cat breakfast.

Trust me when I tell you that we have tried a number of workarounds to help avoid this daily cat alarm clock.

We have attempted to ignore his screams. We have tried feeding him a bigger meal later at night before bed. And we have left dry food out overnight.

We even gave him a late-night catnip snack in hopes that it would help him sleep later into the morning.

Goose doesn’t give a shit about any of that. He still gets up at 5 a.m. every single morning so that we can feed him.

Turns out, though, this daily ordeal may actually be helping me manage my chronic pain from Ehler-Danlos syndrome.

GOOSE AND CRYSTAL

New research from Cigna shows that having a strong sense of purpose can help offset the effects of chronic disease. And every single morning, Goose makes sure that I know that my purpose is to take care of him.

Cigna researchers found that while adults with chronic conditions usually have much lower vitality scores than those who are not sick, the same does not hold true when they also have a strong sense of purpose. 

Adults with chronic conditions and a strong sense of purpose actually have a significantly higher vitality score — nearly matching the scores of people without health issues. Cigna defines vitality as the ability to pursue life with health, strength and energy. 

People with a strong sense of purpose are significantly more likely to have vitality than those who do not (89% vs. 61%). They are also five times more likely to say they feel energized (63% vs. 13%) and nearly three times as likely to look forward to each new day (86% vs. 31%).

Notably, having a strong sense of purpose is linked to greater ownership of physical health — 84% of adults with strong purpose say they feel in control of their health vs. 55% of those without strong purpose. People with a strong purpose are also more likely to get regular exercise, sleep better, and to see their doctors for regular checkups. They also have less anxiety and depression.

“Having a sense of purpose gives people energy and helps them feel happier and healthier,” says Stuart Lustig, MD, National Medical Executive for Behavioral Health at Cigna. “When you know what matters to you, you’re more likely to bounce back from tough times, build strong friendships, and take care of yourself, which impacts your overall physical health.”

It can be easy to shrink into yourself when you’re dealing with chronic health problems, especially when it comes to chronic pain. And truth be told, one of the reasons I resisted my fiancé’s pleas to get a cat in the first place is that I was worried I wouldn’t be able to take care of the cat on bad pain days. 

But as fate would have it, having Goose actually helps me get through the bad pain days —  especially when he is waking me from a deep sleep by screaming for breakfast. In fact, Goose and his cat sisters give my life meaning and make me feel needed every morning, even on the days when I don’t feel like I have much to give.

Of course, you don’t have to get a cat to have a sense of purpose. You don’t even need to have a constant level of activity. Small, gentle acts of generosity can go a long way. 

There are many things in my own life beyond my cats that help me see the world outside of myself and my chronic pain. I also care for my elderly grandma, babysit my niece, volunteer at a local animal shelter, and cook for my family on a regular basis. I also write these columns, which gives me a very direct connection between my pain and my purpose. 

Finding purpose can happen in a million small ways, throughout the days and years. As the old saying goes, it’s better to give than to receive.  And ultimately, when you give, you do, in fact, receive.  

7 Gift Ideas for People with Chronic Illness

By Crystal Lindell

Black Friday marks the unofficial start of the holiday shopping season, and that means hunting for the perfect gifts for those we love.

Below are some gift ideas for loved ones with chronic pain and illness. It’s a gift list you can trust because it’s all based on my own experiences of living with daily pain myself for over a decade.

All of these items also make a great addition to your own holiday wish lists, if you have chronic condition yourself. 

1. Comfy Clothes

The #1 must-have fashion item for people with chronic pain is any clothes that are super comfortable. 

When you have chronic pain, clothing comfort just takes precedent over the latest trends. 

I personally have re-purchased these comfy pants more than 7 times over the last few years. I love how soft they are, and I love that they have pockets! 

But any comfy clothes, from sweat shirts to pajama pants, make a great gift for those with chronic pain. 

Find Women’s Jogger Pants on Amazon 

2. Heated Blanket

There’s nothing better than getting under a cozy heated blanket when you’re dealing with chronic pain. Even if someone already owns one, there’s always a need for one more! 

This heated blanket is my favorite and not only do I own two myself, I’ve also purchased it as a gift for loved ones over the years. And all of them always come back to tell me how much they love it! 

Find this Heated Blanket on Amazon

3. Reminders of Your Love

Little trinkets like a keychain can be a great way to give a constant reminder of your love for someone. Every time they see it, they can think of how much you care about them. 

This keychain features the phrase, “May you always have one more spoon.” It’s a reference to the Spoon Theory, which uses spoons to illustrate the limited energy that people with chronic pain and illness often have. 

It doesn’t have to be a key chain though. A special coffee mug or a bracelet can also make great gifts! 

Find the Spoon Theory keychain on Amazon 

4. Lego

Of course, it doesn’t have to be Lego specifically, but any sort of home-based hobby activities are great for people with chronic pain. 

I personally love this Lego Cat because I’m a huge cat person as well as a huge Lego fan. 

But you can also get your loved ones art supplies, crafting tools, or any other projects they can work on at home.

And bonus points if they can do it from the couch on bad pain days. 

Find the Lego Tuxedo Cat on Amazon 

5. A Good Book

Some days, a pain flare means I don’t have the energy to do anything other than read a book. So having good ones around that I know a loved one recommends is always welcome! 

I recently read The Frozen River by Arial Lawhon, and I really enjoyed the cozy winter setting and completely immersive 1700s plot. 

But you can really buy any book that you’d recommend to share as a gift with your loved ones. 

Also be sure to check out PNN’s holiday reading guide, which has books to help you better understand and treat many chronic pain conditions.  

Find The Frozen River on Amazon 

6. Bread Machine

While a bread machine may not seem like a gift typically associated with chronic pain, it’s actually perfect.

A good bread machine makes it super easy to whip up homemade bread, even when you’re also dealing with a pain flare. You just toss the ingredients in, hit start and presto! A perfect loaf of homemade bread!

It’s also great for anyone on a restrictive diet, since you can easily customize the ingredients. There’s even a setting for a gluten-free loaf! 

Find the Bread Machine on Amazon 

7. Gift Cards

Of course, when in doubt, it’s always a good idea to go with a gift card, especially if you’re shopping at the last minute — because the cards can be instantly delivered via text. 

That way your loved one is guaranteed to get the perfect holiday gift, because they pick it out themselves!

Happy shopping this holiday season!

Find Gift Cards on Amazon

We hope you have happy holidays, and many low pain days in the year ahead! 

PNN makes a small commission, at not additional cost to you, on items purchased through Amazon. 

A Holiday Reading Guide for People Living with Chronic Pain

By Pat Anson

Is kratom really as dangerous as public health officials say it is? What foods can help reduce pain and inflammation? Why do some people get Long Haul Covid and others don’t? How can I manage pain flares from Ehlers-Danlos syndrome? What is percutaneous hydrotomy and why is it growing in popularity with injured athletes?

The answers to these and other questions can be found in PNN’s annual holiday reading guide. If you live with chronic pain and illness or have a friend or family member who does, here are 12 books that would make great gifts over the holidays. Or you can “gift” one to yourself. Click on the book cover or title to see price and ordering information.

The Essentials of Ehlers-Danlos Syndrome

This book is intended to help people understand and manage Ehlers-Danlos syndrome (EDS), a genetic and painful disorder that presents as a confusing set of symptoms that are often misdiagnosed. Topics covered include the 7 sub-types of EDS, what specialists to see, and how to create a personalized care plan to manage pain flares and fatigue.

Kratom: Facts, Myths, and Cultural Insights

This is one in a series of books by Adrian Colewood that seeks to present a balanced and neutral view on kratom, a controversial supplement used by millions to relieve pain, anxiety, depression and withdrawal. With kratom facing new regulations and outright bans due to its opioid-like effects, the book explores the myths and misinformation about a medicinal plant that’s been used for centuries in southeast Asia.

Handbook for Newly Diagnosed Cases of Adhesive Arachnoiditis

This second edition of Dr. Forest Tennant’s book for new cases of Adhesive Arachnoiditis (AA) explores the treatments that can reduce the symptoms of this debilitating spinal nerve disease. Left untreated, AA can result in intractable pain, a bed-bound state, and premature death. This handbook summarizes Dr. Tennant’s 3-step protocol to suppress inflammation and autoimmunity, regenerate damaged tissue, and control pain caused by AA.

Eat to Heal: Unlock the Healing Power of Food

After years of suffering from chronic migraine, fatigue and cancer pain, Dr. Joseph Jacobs turned to nutrition, developing the Advanced Soft Tissue Release (ASTR) diet to reduce inflammation, relieve pain and restore energy. In this book, he shares how eating the right foods helped him beat chronic pain from the inside out, while debunking the myths of so-called “healthy diets” that have left millions of people chronically sick and fatigued.

The Comprehensive Guide to Ibuprofen

Aldrin Gomes, PhD, and his team of researchers at UC Davis look at the benefits and risks of ibuprofen, one of the world’s most widely used pain relievers. Like many NSAIDs, ibuprofen increases the risk of heart attack, stroke and stomach ulcers — even at regular doses — and may interact with hundreds of medications. Studies suggest ibuprofen may also have some surprising health benefits, such as lowering the risk of dementia.

It Doesn’t Have to Hurt: Your Smart Guide to a Pain-Free Life

CNN medical correspondent Dr. Sanjay Gupta is a neurosurgeon by trade who believes all pain starts in the brain, and chronic pain “comes with baggage attached.” Gupta is not a fan of opioid medication, and thinks the body’s own pain relief system can be primed through meditation, sleep, nutrition, acupuncture and physical therapy such as foam rolling. He calls pain “the most mysterious of all human sensations.”

Hip Pain Relief For Seniors

This book is designed for older adults who want to overcome hip pain and limited mobility without surgery or medication. Simple and gentle exercises can be done at home to regain flexibility, strength and movement. These “senior-friendly routines” will help you stay active and independent, including older adults recovering from hip replacement or arthritis.

Secrets to Long Haul Viral Recovery

Author Michael Alcock is a “long-hauler” from Covid-19 and the Epstein-Barr virus, who spent a decade researching why some people are more prone to long-haul viral infections, while others recover easily. This book explains how to recover holistically from viral infections like long Covid by strengthening the immune system through better nutrition, vitamins and supplements.

The Complex PTSD Workbook for Self-Healing

Has chronic pain or a chronic illness left you exhausted — physically and emotionally? Do you live in dread of another pain flare or sleepless night? Alex Carter wrote this self-help handbook to guide you on a 6-week action plan to overcome Post Traumatic Stress Disorder (PTSD) with practical ways to help quiet your mind and nervous system.

The Headache: The Science of a Most Confounding Affliction

Over 3 billion people worldwide suffer from a headache disorder, including author Tom Zeller Jr., who suffers from cluster headaches. Zeller wrote this book to better understand what causes migraines and headaches, and why there are few effective treatments for such a common condition. Zeller looks at the inner workings of the human nervous system and provides a vivid account of the disabling pain that headache sufferers endure.  

Complex Regional Pain Syndrome

Complex Regional Pain Syndrome (CRPS) is a debilitating chronic nerve disease that is usually caused by trauma and can strike any part of the body. This book, edited by Drs. Lynn Webster and Jijun Xu, is part of the "What Do I Do Now? Pain Medicine" series. It looks at 11 clinical cases of CRPS and how they were treated with conventional analgesics and novel therapies, including neuromodulation and ketamine infusions.

Stopping Pain: A Simple, Revolutionary Way to Stop Chronic Pain

Chances are you’ve never heard of percutaneous hydrotomy, a minimally invasive regenerative treatment in which a sterile saline solution is injected into the body to relieve musculoskeletal pain and “flush out” inflammatory substances. Percutaneous hydrotomy has been used in Europe for 30 years and is gaining popularity with amateur and professional athletes who want to stop pain, heal nagging injuries, and boost performance.

These and other books about living with chronic pain and illness can be found in PNN’s Suggested Reading page.  PNN receives a small amount of the proceeds -- at no additional cost to you -- for orders placed through Amazon.

A Pained Life: Should Doctors Be More Curious?

By Carol Levy

In my last column, I wrote about doctors needing more empathy. I feel it’s important for them to understand and relate to whatever their patients are experiencing.

I have been sick for a few months, a jaw infection that keeps coming back. The left side of my face, the side with the trigeminal neuralgia, is where the swelling is located. 

The doctors all seem afraid to try and figure it out: “Well, it's probably related to the issues you already have there.”

If that were true, the swelling wouldn't be new. But it is, and that doesn't seem to faze them.

My family doctor referred me to a bunch of different specialists. Some actually touched the area of swelling, but other than a cursory heart and lung check, they did nothing but order blood tests, an MRI and CAT scan. All were negative. 

Then they threw antibiotics at it. That too didn’t help. Maybe that means they should look into it further, maybe by examining me? It doesn't happen. I merely get, in one form or another, “I haven't a clue. Sorry I can't be of more help.”

All of them were nice to me. Some even showed empathy. That made me feel heard. And yet, I wasn't heard. Had I been, they would have done more than the basic exam and tests. 

I thought a connection, through empathy, would enable more trust in doctors, more acceptance of a diagnosis or lack of one. 

It turns out, it’s not a question of empathy, but a lack of curiosity that makes me doubt their medical ability. Is a lack of curiosity the same as indifference? Do they just not care?

So many of us have experienced this when we present to a doctor with chronic pain. First of all, pain is wholly subjective. They have to choose to believe us (or not) when we say we are in pain. Then they have to make an effort to find the cause. That almost requires them to do a full exam, to show curiosity about our bodies, and therefore our pain.

It seems to me, if someone decides to go to medical school, curiosity has to be a motivator. Curiosity about how our bodies work, what happens when they don't, and what causes them not to work as they should.

What happens to that curiosity? Do doctors become jaded? Does the thought process go something like this: “I don't need to do an exam. Blood work and x-rays will tell me, and if they don't, that's the way it goes.”

I find I have to ask my doctor if it could be this or that. I have to suggest that he order an x-ray. It seems to be my job to come up with ideas. Since there is an infection, maybe there is an underlying disorder? 

Sometimes he merely shrugs.  Other times, he goes with my suggestions.

Maybe that makes it a partnership, but it’s one based on my work and thoughts, not his. And it’s all based on my curiosity about what is making me sick. 

Somehow, that feels wrong. Because, after all, isn’t being curious enough to figure out what is wrong the doctor's job?

Carol Jay Levy has lived with trigeminal neuralgia, a chronic facial pain disorder, for over 40 years. She is the author of “A Pained Life, A Chronic Pain Journey.”  Carol is the moderator of the Facebook support group “Women in Pain Awareness.” Her blog “The Pained Life” can be found here.  

Does Mindfulness Really Help with Chronic Pain?

By Neen Monty

“Mindfulness” is one of those words that’s been stretched so far it’s almost lost its meaning. We’re told it will calm our nerves, ease our pain, and maybe even transform our lives. 

But what is mindfulness, really? And what can it actually do for people living with chronic pain?

The popular definition goes something like this: Mindfulness is the practice of focusing your awareness on the present moment, without judgment.

Does that make sense to you? It didn’t make sense to me the first time I heard it. It sounds so simple… but it’s not so simple to do.

Most people think mindfulness is meditation. It’s not. Mindfulness is a state of awareness, a way of relating to your thoughts and sensations, while meditation is a tool that helps you develop that state. Meditation is how we practice mindfulness, the training ground for the skill of self-awareness.

Clear? As mud…

Okay, let me try again. At its core, mindfulness rests on two ideas:

1. Paying attention to the present moment.

2. Doing so without judgment.

That second part is the hardest. It can take a lot of practice. But in practical terms, living mindfully is living in the present moment. It’s not wasting time worrying about a future that may never happen, or dwelling on a past that can’t be changed.

The Difference Between Pain and Suffering

Let’s use pain as an example. Being mindful doesn’t mean ignoring pain or pretending it’s not there. It means noticing it: “I feel pain right now” and stopping there.

What we usually do next is the problem: “Oh no, it’s back. The pain is so bad! It’s going to get worse. I can’t take this anymore.”

Those thoughts are the suffering part. They layer emotion, fear, and meaning on top of the physical sensation of pain.

Mindfulness helps peel that layer away. Pain still hurts, but without the extra story, the extra worry, the panic, the hopelessness and the emotional response. It’s just pain.

Pain then becomes something we can observe, without emotion, rather than something that swallows us whole. This distinction isn’t just philosophical. Brain imaging studies show that mindfulness changes the way we process both thoughts and sensations.

Meditation strengthens brain regions that regulate attention and emotion, such as the prefrontal cortex and anterior cingulate cortex, while reducing reactivity in the amygdala, the brain’s alarm system. Other reviews confirm that meditation produces measurable neurobiological changes that are associated with greater emotional stability and self-regulation.

Over time, meditation helps the mind become less reactive. We learn to notice sensations, thoughts, and emotions without immediately trying to fight or fix them. 

Instead of launching into fight or flight, we remain calm and in control. Meditation, in that sense, is kind of the laboratory in which mindfulness is trained.

The Limits of Mindfulness

Does mindfulness cure pain? No. It does not.

Systematic reviews and meta-analyses find that mindfulness training has only small effects on pain intensity. What it does reduce is distress — the anxiety, fear, and emotional turmoil that often surrounds chronic pain.

That distinction matters. Mindfulness was originally designed as a treatment for stress and anxiety. And therefore, its benefits for pain are more indirect. It helps people who are fearful of pain or overwhelmed by it, to regulate their emotions and cope better.

But, if you’re already calm and accepted your pain without fear, mindfulness won’t make the pain go away. It won’t have much effect at all on your pain.

Most importantly, mindfulness is not a treatment for severe pain. You cannot be mindful and you cannot meditate, when you’re in severe pain. Mindfulness is not an intervention for 8 or 9/10 pain. That’s pure cruelty. I would even call that medical negligence.

Mindfulness is a treatment for fear and anxiety in the setting of chronic pain. In that sense, mindfulness may be helpful for someone in mild to moderate pain, where there is a lot of negative emotion surrounding that pain – such as fear, anxiety and catastrophising.

Mindfulness is a psychological tool, a treatment for fear and anxiety that’s been repurposed for pain. 

And often oversold as something it’s not.

Why Mindfulness Is Still Worth Trying

Even within those limits, I still believe mindful living is the best way for me to live. It doesn’t make my pain stop. My pain is caused by disease, pathology and biology, not by anxiety or fear.

Mindfulness does make my days quieter. It keeps me from being dragged into fear or frustration. I don’t worry about the future and don’t dwell on the past. Mindful living keeps me grounded. In the present moment. Because that’s where life is happening – the here and now.

That’s what mindfulness is, living in the present moment.

Mindfulness won’t fix what’s broken in the body. Mindfulness cannot fix pathology. But it can help restore what pain often breaks in the mind: calmness, control, and your sense of peace in the middle of chaos.

And sometimes, that’s enough.

Neen Monty is a patient advocate in Australia who lives with rheumatoid arthritis and Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), a progressive neurological disease that attacks the nerves.

Neen is dedicated to challenging misinformation and promoting access to safe, effective pain relief. She has created a website for Pain Patient Advocacy Australia to show that prescription opioids can be safe and effective, even when taken long term. You can subscribe to Neen’s free newsletter on Substack, “Arthritic Chick on Chronic Pain.”